All prices quoted in this flyer are based on airfares, land and exchange rates in effect in November 2017. All prices are subject to change without notice prior to departure due to major currency fluctuations, fuel price increases and/or unforeseen economic conditions. We reserve the right to change the price of this tour and to change the hotel and itinerary without previous Notice.

DEPOSIT:

Deposit of $500.00 per person is required at time of booking to secure reservation.

Balance is due no later than April 01, 2017

Please complete the registration form with full name as it appears on passport, and mail it to us with your check for $450.00 per person. Receipt of your deposit shall act as your agreement to the terms and conditions herein. Your cancelled check constitutes your receipt.

CANCELLATION & REFUND Fees - Days Prior to departure

$450.00 Registration Fee (not refundable)

$1250.00 125-80 Days prior to Departure

$1,850.00 79-51 Days prior to Departure

100% of total tour 49-0 Days prior to Departure

All refund claims must be received in writing by The Lay Institute of Divine Mercy headquarters office in Los Angeles, California. Once the Tour begun, there will be no-refunds made for any unused or partially used Tour feature or services, including hotel accommodations and car rentals. In all cases, cancellation fees will apply and be non-refundable for any reason, including illness or other emergencies. The Tour operator and The Lay Institute of Divine Mercy reserve the right to cancel the tour.

Name *

Name

First Name

Last Name

Name of Pilgrimage

Phone *

Phone

Day

(###)

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####

Evening

(###)

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Date of Birth *

Date of Birth

MM

DD

YYYY

Gender *

U.S. Citizen with Valid Passport *

Yes

No

If no, what Country

Passport No. *

Date of Issue *

Date of Issue

MM

DD

YYYY

Exp. Date *

Exp. Date

MM

DD

YYYY

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parish

Email Address *

Rooming with

Signature *

By signing this form you have agreed that all given content is correct